Nutrition, Strength and Balance Tips to Become a Healthier You!
Jenna Faiella, Jen MacPherson, Jordan Rosenberger, Bill Nixon, Jered Nelson, David Shepard Prize Giveaway!! At the end of the each presentation, there will be a series of questions Answer correctly, and you will receive a small prize!! Presentation Objectives
Based on a Needs Assessment Survey administered at the Gunning Center on Friday, September 11, 2015 from 10:30-11:30 am, Nutrition, Strengthening and Balance were deemed to be the topics with the most interest. With this in mind, the following Learning Objectives were created: Learners will demonstrate proper strength training exercises in a safe and effective manner. Learners will identify at least three benefits to strength training related to health and well-being. Learners will explain why the PAR-Q+ is important to complete before exercise. Learners will connect with the importance of balance improvement to manage fall risk. Learners will be able to identify good sources of select essential vitamins and minerals 2015 PAR-Q + 1 Physical Activity Readiness Questionnaire for Everyone
Purpose: To screen all individuals to ensure it is medically safe to exercise Goal: Identify individuals who may need further medical screening before beginning an exercise program ***Relate back to when we came in the summer for medical screening and they filled out the ParQs before they participated What is the PAR-Q +? Series of health questions that should be answered prior to beginning an exercise program Includes the following categories: General health Chronic medical conditions Arthritis, cancer, cardiovascular disease, diabetes, mental health Importance: SAFETY first and foremost! PAR-Q + Scoring An answer of yes to any of the follow-up questions indicates consultation from your doctor before beginning an exercise program An answer of no to any of the follow-up questions indicates you are ready to exercise! PAR-Q + Take Home Message
Exercise can be fun and healthy! Always practice safety when beginning an exercise program! If you are unsure of your abilities to participate in an exercise program, ask your doctor. Nutrition Introduction Video 2 Nutrition DASH Eating Plan 3, 5
DASH Dietary Approaches to Stop Hypertension Effective for both people with and without high blood pressure to help maintain or lower blood pressure Flexible and balanced eating plan that promotes heart healthy eating Recommendations: Vegetables, fruits, whole grains Research has shown an association of vegetable consumption with muscles and grip strength Fat-free or low-fat dairy products (fish, poultry, beans, nuts andvegetable oils) Limiting foods high in saturated fats (fatty meats, full dairy products and tropical palm oils) Limiting sugar-sweetened beverages and sweets Nutrition What is a Serving Size? 3
The DASH Nutrition Plan is based on serving sizes in each food category Examples of how to measure serving sizes: Two Tablespoons Three ounces of Meat or Poultry 1 1 Ounces Nutrition More Serving Size Examples 3
Three ounces of grilled/baked fishOne Cup cooked veggies, salad, baked potatoThree ounces meat/poultry Nutrition More Serving Size Examples 3
Half cup of fruit, beans, One teaspoon margarine or oil noodles or ice cream One pancake or tortillaQuarter cup of raisins or other nuts DASH Plan How Much from Each Food Group? 3
When following the DASH plan it is important to choose foods: Low in saturated and trans fats Low in sodium 2300 mg of sodium is allowed, but the less sodium included in the diet the greater effect the plan will have on lowering your blood pressure Rich in Potassium, Calcium, Magnesium Fiber and Protein While presenting give further examples of foods that fit into each food group Nutrition Changes with Aging 3, 4, 6
Vitamin and Mineral Deficiencies Less efficient absorption Altered Metabolism and Excretion Increasing Use of Medications Decreased Protein Decreased Lean Body Mass Increased Protein Turnover BUT Eating recommended levels of vegetables (4 5 servings daily) is associated with 48 % less chance of having Lower Muscle Mass Broccoli, cauliflower, radishes, kale, Brussel sprouts and cabbage https://monashdental.wordpress.com/2013/12/02/vitamins-and-minerals-for-good-oral-health-of-your-kids-2/ Nutrition Vitamins 3, 5, 6 Vitamins Help your body grow and function
Considerations Vitamin B6 Essential for nerve tissue, metabolism of fats, helps regulate body fluids Vitamin C Essential for healthy teeth, bones, joints, immune system and muscle contraction Vitamin D Important for health, bones, teeth, collage, cartilage, nervous system and the heart. Also aids with blood clotting Greater Vitamin D intake has been associated with fewer falls Vitamins Help your body grow and function Resist infections Keep the nerves healthy Help the body get energy from food Blood Nutrition Vitamin Intake 3, 4, 6
It is best to get the appropriate amount of Vitamins through your diet instead of through supplementation Check labels on products to know amounts in each food source Natural Sources: Vitamin B6 Whole grain cereals, bananas, potatoes, lentils, turkey Vitamin C Citrus fruits and juices, Tomatoes, Green Peppers, Strawberries Vegetables!! Vitamin D Fish liver oil, eggs, sunshine Fortified in milk, cereal and some orange juice and bread Calcium Recommendations Adults 50+
Nutrition Minerals 3, 7 Help your body function optimally Calcium Important for strong bones and teeth and the health and functioning of nerve, brain and heart tissue Sources: Milk, Milk-Products (fat-free or low-fat when possible) Dark- Leafy Greens Collard Greens/Kale Soybeans Canned Sardines Salmon Calcium Recommendations Adults 50+ Women 51+ 1200 mg/day Men 51-70 1000 mg/day Men 71+ *Both women and men 51+ should not be consuming more than 2000 mg of calcium Nutrition Bottom Line
DASH Diet to Help Decrease and Maintain Blood Pressure Serving Sizes to Eat Adequate Portions of Each Category Vegetables! Good source of Vitamins and Minerals Research has found association between vegetables and grip strength Eating recommended serving size associated with 48 % less chance of having Lower Muscle Mass Nutrition Questions?! Time for Prizes! Question 1 : What is one benefit of eating the recommended servings of vegetables every day? Answer : Increased Grip Strength Good source of Vitamins and Minerals
3 Possibilities: Increased Grip Strength Good source of Vitamins and Minerals A Decreased Chance of Having Low Muscle Mass Question 2 : What is one of the three ways discussed to remember how big a serving size of 3 ounces is? Answer: A deck of cards A checkbook The palm of your hand Why is it important to complete the Par-Q+ before exercising?
Question 3: Why is it important to complete the Par-Q+ before exercising? Answer: Safety first & foremost!
To ensure it is safe to start an exercise program Why is strength training important?
[Ask the Audience] Picture: Muscle Changes with Age10
Human aging is associated with muscle atrophy (loss of muscle tissue), weakness and functional impairment, which starts in the 4th decade of life There is a rate of strength loss of about 1.0% per year, accelerating with each passing decade Greatest decline occurs after age 70 with inactivity or illness 10. Doherty TJ. Invited review: Aging and sarcopenia. J Appl Physiol. 2003;95:17171727. [PubMed] Sarcopenia: Loss of muscle tissue as a natural part of the aging process. Picture: Can I prevent/slow down the natural aging process???
Picture: YES, YOU CAN! Exercise is one of the best ways to slow or prevent problems with the muscles, joints, and bones. A moderate exercise program can help you maintain strength, balance, and flexibility. 9 11. https://www.nlm.nih.gov/medlineplus/ency/article/ htm Pictures: Benefits to Strength Training8
Fall Prevention Falls are the second leading cause of accidental or unintentional injury/deaths worldwide, with adults older than 65 suffering the greatest number of fatal falls Stress Management Enhances Overall Mood Functional Benefits Improves Sleep 8. Functional Benefits getting up from a chair, climbing stairs, carrying groceries, playing with grandkids, etc. Picture: https://www.nia.nih.gov/health/publication/exercise-physical-activity/sample-exercises-strength https://www.nia.nih.gov/health/publication/exercise-physical-activity/sample-exercises-strength More Benefits! Slows down/prevents many negative effects of aging (such as Osteoporosis, Sarcopenia, etc.) by reducing the risk of falls & fractures Improves bone health & cognitive ability Picture 1: Picture 2: Picture 2: How much? How often? 11 The National Institute of Aging (NIH) suggests: or more days per week of strength training for 30-minute sessions each Start out slowly, doing easy exercises with light weights and then eventually increasing the weight and length of time you exercise Work your way up to doing repetitions for each exercise, 2-3 sets Switch it up! Do not exercise the same muscle group two days in a row -- Allow time for the muscles to rest *On handout provide website for NIH strength Safety Warm up and cool down at least minutes before and after strengthening exercises Remember to breathe! Focus on proper form Smooth and steady motions Proper footwear & clothing Muscle soreness and slight fatigue are normal after muscle-building, at least at first after doing these exercises for a few weeks, you will probably not be sore after your workout.11 Picture: Before you Start Tips & Pointers!
Talk with your doctor11 Challenge yourself You may be over-exercising if you; Experience pain or a feel ill immediately after exercise Feel overly exhausted Experience sore, painful joints or muscles Over-exercising can cause injury, which may lead to quitting altogether.A steady rate of progress is the best approach! Doctor: consult with your doctor to determine what type of strengthening program is appropriate for you **especially if you have had previous surgeries including TKR or TKH or any other injuries or diseases that may require limitations to your movement Challenge: listen to your body, if you feel exhausted or overworked stop the exercise, take a day off and rest, do not over do it, that will only set you back and increase your risk for injuries Over doing it: some muscle soreness is typical and normal in the few short days following a workout but, you should never feel extreme pain or feel nauseous post-exercise Types of Strengthening
Body weight No equipment needed! Weights Be Creative! Use household objects & save money! Therabands Exercise Classes (Water aerobics, Tai Chi, Yoga, ballroom dancing) https://www.nia.nih.gov/health/publication/exercise-physical-activity/sample-exercises-strength Therabands: demonstrate, pass out for participants to try? Inexpensive and can be adjusted for height, or arm span Ex classes: good for mind and body, Silver Sneakers (provide resources around Dont have weights? Can use household items: Use common grocery items, such as bags of rice, vegetable or soup cans, or bottled water. Picture: https://www.nia.nih.gov/health/publication/exercise-physical-activity/sample-exercises-strength Arm Exercises Tricep Extensions13
Functional Use: Getting out of a chair, pushing doors open Tips: Sit up straight with feet firmly on the ground Arms overhead Only bend at your elbow! Modifications: Arms at sides or seated Progress: By adding weights **always start with a warm-up such as walking in place 2 sets of reps for all exercises *explain what repetitions and sets mean *Focus on breathing! concentric exhale eccentric inhale Arm Exercises Arm Raises to the front and side13
Functional uses: lifting groceries, carrying grandchildren Tips: Back straight and feet shoulder width apart Palms facing down and elbows straight Hold the position for 1 second Modifications: Raise arms within your comfortable range, raise only one arm at a time Progression: Lift with both arms at the same time, lift while standing to incorporate balance, increase weight https://www.nia.nih.gov/health/publication/exercise-physical-activity/sample-exercises-strength Leg Exercises Leg Raises to the front, back and side13
Functional Use: Improves balance and strength needed for walking Tips: Stand with legs shoulder width apart Hold on to a chair Breathe! Modifications: Front leg raises can be performed seated or side raises can be performed laying down Progression: Lessen grip on chair, add ankle weights or therabands https://www.nia.nih.gov/health/publication/exercise-physical-activity/sample-exercises-strength Leg Exercises Squats12 Functional Use: Sitting down and standing up
Tips: Stand shoulder width apart Back straight You should always be able to see your toes Dont forget to breathe! Modifications: Hold on to the back of a chair or squat into a chair Progress: Add weights or a backpack https://www.theinsidetrainer.com/7569/resistance-chair-workout-routines/ https://www.youtube.com/watch?t=438&v=-jeddHew-Vo https://www.theinsidetrainer.com/7569/resistance-chair-workout-routines/ *Table in front of them, squatting down into chair Bottom Line: Make exercise safe, interesting, fun, social, and a priority Strength training is a great way to prevent the normal aging process There are many ways to be active every day. Find something you enjoy doing, include it in your regular routine, and try to increase your level of activity over time. Any Questions?! Time for Prizes! Name 3 benefits of Strength Training
Question 1: Name 3 benefits of Strength Training Answer: Fall prevention Stress management Enhanced mood
Functional benefits (lifting groceries/grandchildren, walking, etc.) Improves sleep Slows down/prevents effects of aging Improves bone and cognitive health How do you know if you are overtraining?
Question 2: How do you know if you are overtraining? Answer: Pain or illness after exercise Overly exhausted
Extreme pain in joints or skeletal muscles What is Balance? -Ask the audience if they can tell me what balance is? Balance Controlling the bodys center of mass (COM) with respect to its base of support8 https://osteopathysingapore.files.wordpress.com/2015/05/line-of-gravity.jpg Types of Balance Static Balance Dynamic Balance
Static balance- posture Dynamic Balance walking https://www.agingcare.com/infusionnewssiteimages/agingcare/9b3f6d2d-d52e-47e8-84ab-26d6b9a36983.jpg https://smallgroupfitclub.files.wordpress.com/2011/12/old_people_walking.jpg How We Maintain Balance14
Visual System Provides information about our body movements and position in space relative to the surrounding environment Somatosensory System Provides information about our body movements and position in space relative to the surface of support beneath us Provides information about position and movements of body segments relative to one another Vestibular System Works with the visual system to help determine whether the world or our body is moving when we turn quickly in space Visual System provides us with a visual layout of our surrounding environment and provides critical information about our spatial location relative to objects in that environment. Once we start moving it allows us to navigate safely, anticipate changes in surfaces we encounter, and avoid obstacles in our path. Somatosensory System in the absence of vision (like in the dark) this becomes primary source of balance. Ex: position arm, close eyes, and match it with other arm Vestibular System Located in the inner ear and activated when we move our head. Resolves conflict between vision and somatosensory. For example walking around in the dark on an unstable surface. -All three of these systems work together to help us balance, damage to one can usually be compensated by the other two, but if more than one is affected it impairs our ability to organize and integrate information Age-Related Changes in Vision14
Reduced Acuity (clarity) Depth Perception Contrast Sensitivity Visual Field Other Age-Related Changes in Balance14
Somatosensory Vestibular Reduced Vibration Sense Joint Position Sense Reduced Density of Hair Cells in Inner Ear -With a reduced vibration sense, the ability to feel the contact between your feet and ground becomes diminished -With reduced joint position sense it makes it harder for your body to receive information about where your arms and feet are when standing and walking, making balance tougher. -The hair cells in your ear give you information about head movement, a decline in those cells reduces sensitivity to head movements and results in increased sway -Evidence suggests that these changes can be reversed, or at least slowed, in some of these systems. -Intervention programs that target the source of balance related problems and repeatedly expose older adults to a changing environment have been very effective. How Can I Improve My Balance?18
Though there are often many factors involved with decreased balance as we age, a lot of this decline is simply due to our inactivity and this can be improved with balance training! The risk of falling increases with age and simple balance exercises can help you prevent falls and avoid injuries that may result from falling Home Balance Program 15 Start with the most basic and simplest of exercises The program stresses to incorporate as much of the balance exercises into daily living so it does not feel like work but a more natural functional activity For some of the exercises you will need a chair with no arms preferably or a table/countertop The program will be composed of three exercises with each exercise having progression options 55 42 Home Balance Program : The Basics 15, 16
The best place to start is sitting in a chair where you have the most base of support and safety while starting the program While holding onto a chair, begin weight shifts from side to side and then forward This can be done everyday, start off with what you are comfortable with and make daily goals to increase your time to reach up to two minutes 56 43 Progression: Lessen Points of Contact 15,16
Once this exercise is mastered you can progress by holding onto a surface like a chair or countertop with only one finger as opposed to your full grip. This also can be done everyday, working your way up to a 2 minute session. Once this does not pose a challenge, you can progress to not holding onto any surface at all for the entirety of the exercise. 57 44 Progression: Eyes Closed 17
Once you have mastered the weight shifts in the chair while not holding onto any surface, you can start doing the weight shifts while closing your eyes for the duration of the whole exercise This will challenge your bodys somatosensory system which was covered earlier. https://www.nia.nih.gov/health/publication/exercise-physical-activity/sample-exercises-balance 58 45 Home Balance Program: Standing Balance 15, 16, 17
Once you are comfortable with your sitting balance you can move onto a standing balance exercise. If standing in a double leg stance is easy, progress to a tandem or staggered stance The exercise can be done while holding onto the back of a chair or while at the kitchen sink doing a functional activity. 59 46 Home Balance Program: Advanced 15, 16, 17,18
Once you are comfortable with standing balance in a staggered stance, you can advance to standing on one foot. This can also be done while holding onto the back of a chair or at the kitchen sink. Hold position for up to 10 seconds. Repeat times. Switch legs and repeat times with other leg. Once this gets easy, increase the time you are standing on one foot, trying to work your way up to two minutes! https://www.nia.nih.gov/health/publication/exercise-physical-activity/sample-exercises-balance 60 47 Bottom Line14, 15, 16, 17 Multiple body systems affect balance.
As we age these systems begin to decline, to prevent this from happening people should incorporate balance exercises into their daily lives and activities. Start with the easiest balance exercises to increase body control and safety for harder exercises. Only progress to a new exercise once you can fully master the previous exercise without any loss of balance. 61 48 Any Questions?! Time for Prizes! What two types of balance are there?
Question 1: What two types of balance are there? Answer: Static Balance AND Dynamic Balance Question 2: Why is it important to use a chair or countertop during the standing balance exercises? Answer: Safety! Presentation Take Home Message
Eat appropriate serving sizes of all food groups (especially vegetables) every day Exercising and being active everyday is one of the best ways to slow down the natural aging process There are exercises designed to improve balance, at all levels of experience Safety is ALWAYS the first concern!! 68 Final Questions? https://aimhigherscotland.wikispaces.com/THE+FINAL+QUESTION References 1. PAR-Q & You.CSEP. SCPE.Revised Accessed October 9, 2015. 2. Basic Nutritional Advice: Nutrition Tips for Seniors. Youtube. https://www.youtube.com/watch?v=acuqzRQ7BKI. Uploaded March 13, Accessed October 9, 2015. 3. National Institute on Aging. Whats On Your Plate? U.S. Department of Health and Human Services. https://www.nia.nih.gov/health/publication/whats-your-plate/dash-eating-plan. Accessed October 9, 2015. 4. Bottomley JM, Lewis CB. Geriatric Rehabilitation: A Clinical Approach, 3rd edition. Upper Saddle Rive, NJ: Prentice Hall; 2008. 5. Kim J, Lee Y, Kye S, Chung Y, Kim K. Association Between Healthy Diet and Exercise and Greater Muscle Mass in Older Adults. Journal Of The American Geriatrics Society [serial online]. May 2015;63(5): Available from: Academic Search Complete, Ipswich, MA. Accessed September 16, 2015. 6. Recommendations Abstracted from the American Geriatrics Society Consensus Statement on Vitamin D for Prevention of Falls and Their Consequences. Journal Of The American Geriatrics Society [serial online]. January ;62(1): Available from: Psychology and Behavioral Sciences Collection, Ipswich, MA. Accessed September 30, 2015. 7. Plawecki K, Chapman-Novakofski K. Effectiveness of Community Intervention in Improving Bone Health Behaviors in Older Adults. Journal Of Nutrition In Gerontology & Geriatrics [serial online]. April 2013;32(2): Available from: CINAHL Plus with Full Text. 8.World Health Organization. Falls Key Facts.Accessed October 10, 2015 9. U.S. National Library of Medicine. Aging Changes in Bones, Muscles, & Joints. Medline Plus.https://www.nlm.nih.gov/medlineplus/ency/article/ htm Accessed October 10, 2015 10.Doherty TJ. Invited review: Aging and sarcopenia. J Appl Physiol. 2003;95:17171727. [PubMed] 11. National Institute on Aging. Exercise & Physical Activity: Your Everyday Guide. U.S. Department of Health and Human Services.https://www.nia.nih.gov/health/publication/exercise-physical-activity/introduction. Accessed October 11, 2015. 12. Exercise is Power: Resistance Training for Older Adults. Youtube. https://www.youtube.com/watch?t=438&v=-jeddHew-Vo. Uploaded April 24, Accessed October 11, 2015. 13. National Institute on Aging. Strength. U.S. Department of Health and Human Services. https://www.nia.nih.gov/health/publication/exercise-physical-activity/sample-exercises-strength 14. Rose, Debra. FallProof! A Comprehensive Balance and Mobility Training Program, 2nd edition. Human Kinetics, IL; 2010. 15. Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JCT. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatric Soc2008;56: 16. Clemson L, Fiatarone Singh M, Bundy AC, Cumming RG, Weissel E, Munro J, et al. LiFE Pilot Study: a randomized trial of balance and strength training embedded in daily life activity to reduce falls in older adults. Aust Occup Ther J2010;57:42-50. 17. Clemson L, Cumming RG, Kendig H, Swann M, Heard R, Taylor K. The effectiveness of a community-based program for reducing the incidence of falls among the elderly: a randomized trial. J Am Geriatr Soc2004;52: 18. National Institute of Aging. Balance. U.S. Department of Health and Human Services. https://www.nia.nih.gov/health/publication/exercise-physical-activity/sample-exercises-balance. Post-Assessment Surveys
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